Systemic corticosteroids doses in COPD exacerbations treated with non-invasive ventilation

Objective: Determine the effect of the first corticosteroid dose on success of Non-invasive ventilation (NIV) in COPD exacerbations Methods: Observational, retrospective study. January-2013/June-2015. Patients with ≥ 1,5 mg/kg/day of methylprednisolone in the first 24 hours, were compared to those treated with lower doses. Baseline characteristics, pulmonary function, obstructive sleep apnea, and arterial blood gases (ABG) at admission/discharge were retrieved. NIV failure (No pH correction in 72 hours, need of invasive ventilation, or death). Adverse effects were collected. Quantitative variables with normal distribution ( t -student), with non normal distribution (Kruskal-Wallis). Qualitative variables (Chi-square - Fisher exact correction) Results: 85 COPD patients with exacerbation, in need of NIV. 70 men (82%), mean age 68.6 ± 11.4 years. Mean dose of methylprednisolone 1.67 ± 0.82 mg/kg/first day, 43 patients (51%) were treated with 2 (86.8 vs. 61.5; p=0.001) between admission and at discharge. NIV failure was observed in 18 patients (21%) Conclusions: No differences on NIV success according to methylprednisolone doses. Doses ³ 1,5 mg/kg/day were used in patients with worst ABG at admission, with a slower pH correction, but with a reduced number of days of admission. No differences in adverse effects were observed.